| NPI | 1194493148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 027316) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-09-03 |
| Last Update Date | 2025-11-13 |